The terminal ileitis or regional enteritis is a rare disease whose etiopathogenesis is not yet fully known. Spread throughout the world (particularly in the United States, Britain and Europe), the epidemiological, you notice how the disease is progressively increasing, especially in occidental countries.

The disease affects relatively young individuals equally affects males and females, between 20 and 40 years, however, increasingly frequent reports of first diagnosis in old age. And can affect any part of the digestive tract in most cases; however, is localized to the terminal ileum tract (so called ileitis terminal). An important character is that the lesions are segmental, i.e. involving segments of intestine of variable length (5 to 25 cm).

CAUSE


The cause of the disease, C. is unknown. The hypothesis put forward by various scholars and research is currently directed to ascertain what factors may be responsible for acting on a ground. It is genetically predisposed the most frequent genetic disease in Caucasian subjects, and Jews in the family patients with this disease. Factors that are thought to act are environmental factors, infectious agents, immunological and psychological factors. It is believed that the causal factors are multiple, toxic food, infectious (viruses and bacteria) and that all contribute to cause the level of abnormal type structures intestinal immune reactions. These hypotheses are supported by the discovery today, in subjects suffering from Alzheimer's C., auto antibodies acting against surface antigens of some intestinal cells. The etiology is not also excluding plots with hereditary factors and psychosomatic stimuli.


Anatomopathological framework


The wall of a bowel segment affected by the disease loses its usual luster, is inflamed and thickened, so that the section concerned is transformed into a rigid and inelastic channel with a gradual narrowing of the lumen. There is clear demarcation between healthy and taken ill suddenly. This is perhaps the main characteristic of the condition in question. The first to be affected is the mucus thickens and undergoes localized phenomena of necrosis, with formation of superficial ulcers and irregular. These ulcers deepened very slowly in the other layers of the bowel wall (submucosa, muscular layer and serosa) that the danger of perforation in the peritoneal cavity, leading to generalized peritonitis, practically does not exist. Given the slow progress in the ulcer process makes its way, are formed adhesions between the various loops, as the peritoneum reacts to form a liquid that will result in fibrinous adhesions membranes which incorporate the handles.



It follows that entero-enteric fistula can be created, i.e. abnormal communications between bowel loops, due to the deepening of the ulcer in the loop adjacent, attached to the same ill from adhesions. Sometimes the ulceration can also reach the bend adjacent organs. The views are microscopic lymphatic structures, is very rich in the intestinal wall, to be concerned. The disease process tends to spread to the peritoneal serosa and following the path of the lymphatic vessels of interest to reach the mesenteric lymph nodes that are enlarged and clearly visible.


The symptoms of Chrone’s disease arise subtly. Symptoms of Chrone’s disease vary with the intestinal tract affected and the mode of onset of the disease.